Joint Venture Construction Program

Section 818 of the Indian Health Care Improvement Act, P.L. 94-437, authorizes the IHS to establish joint venture projects under which Tribes or Tribal organizations would acquire, construct, or renovate a health care facility and lease it to the IHS, at no cost, for a period of 20 years. Participants in this competitive program are selected from among eligible applicants who agree to provide an appropriate facility to IHS. The facility may be an inpatient or outpatient facility. The Tribe must use Tribal, private or other available (non-IHS) funds to design and construct the facility. In return the IHS will submit requests to Congress for funding for the staff, operations, and maintenance of the facility per the Joint Venture Agreement.

Proposals considered under this program are evaluated against the following criteria:

The need for space at the location is verifiable when evaluated by using the criteria in the

IHS planning methodologies;

The Tribe is able to fund and manage the proposed project using its own (non-IHS)

funds;

The project is consistent with the IHS Health Systems Planning program; and

The project is consistent with the IHS Area Health Facilities Master Plan.

Additional consideration is given to Tribes that elect to fully fund the equipment for the facility.

Post Occupancy Evaluations Program

The Indian Health Service conducts Post Occupancy Evaluations (POE) of recently completed health care facilities to gain knowledge for improvement of the planning and design process for new health care facilities as well as to encourage overall improvement in the health delivery process by providing the best health care facilities possible. The major purposes of a POE include:

To avoid repetitious design or construction deficiencies.

To document noteworthy construction features or practices for inclusion in future projects.

To evaluate the entire plan-design-construction-operation process. After the evaluation, feedback will be provided to those offices which were responsible for the planning, designing, constructing and operating processes.

To save future construction and operating costs by contributing to an efficient facilities design and construction program.

To evaluate staffing patterns and determining the adequacy of the space provided compared to the approved Program of Requirements.

To verify that the functional requirements of the Program of Requirements are met, and that they are met at reasonable costs. The operating program and technical survey team jointly evaluate this item.
Generally a POE is conducted after the initial construction and start-up defects are corrected and the facility is in full operation, 2 to 4 years after initial occupancy. This time period also allows the staff an opportunity to become familiar with the facility and to implement procedures for utilizing their department spaces.

Small Ambulatory Grants Program (SAP)

Section 306 of the IHCIA, P.L. 94-437, authorizes the IHS to award grants to Tribes and/or Tribal organizations for construction, expansion, or modernization of ambulatory health care facilities located apart from a hospital. Where non-Indians will be served in a facility, the funds awarded under this authority may be used only to support construction proportionate to services provided to eligible American Indian and Alaska Native (AI/AN) people. The last year that IHS received appropriations to fund the Small Ambulatory Program was in 2006.

Participants in this program are selected competitively from eligible applicants who meet the following criteria:

Only federally recognized Tribes that operate non-IHS outpatient facilities under P.L. 93-638 contracts are eligible to apply for this program.

Facilities for which construction is funded under Section 301 or Section 307 of P.L. 94-
437 are not eligible for this type of grant.

Priority will be given to Tribes that can demonstrate a need for increased ambulatory health care services and insufficient capacity to deliver such services.

The completed facility will be available to eligible Indians without regard to ability to pay or source of payment. Youth Regional Treatment Centers

The applicant can demonstrate the ability to financially support services at the completed facility.

The completed facility will:

Have sufficient capacity to provide the required services.

Serve at least 500 eligible AI/AN people annually.

Provide care for a service area with a population of at least 2,000 eligible persons